Goodpasture's Syndrome

What is Goodpasture's Syndrome?
Goodpasture's Syndrome is an uncommon disease causing injury to both your kidneys and lungs, brought on by your body's own antibodies. If you have the disease, you will usually have:

• bleeding from the lungs
• coughing up of blood
• inflammation of the kidney (glomerulonephritis)

Usually, you have these signs and symptoms because your body is making antibodies that hurt the lining of your lungs and kidneys. This problem is most common in Caucasians and less common in people of African or Asian origin. Sometimes, you will have these signs and symptoms with other diseases, such as lupus erythematosus or Wegener's granulomatosis.

The lung disease may cause life-threatening bleeding but does not usually cause long-term harm to your lungs. However, the harm done to your kidneys can result in kidney failure. You may need either dialysis or a kidney transplant. If your kidneys are being harmed, you may:

• feel very tired
• have blood and/or protein in your urine
• have back pain below your ribs
• need to pass urine more often, especially at night
• have burning or difficulty when urinating
• have swelling of your hands and feet
• have high blood pressure.

What causes Goodpasture's Syndrome? How is it diagnosed?
We do not know why your antibodies begin attacking your own body, although genetic and environmental factors may play a role. Usually, antibodies only do helpful things such as fighting infections.

Your doctor will examine you thoroughly. There is a specific blood test that can tell if you have this harm- ful antibody. Your doctor may also do a kidney biopsy (look at a small piece of kidney tissue under a micro-scope) to see if the antibody is present in the kidney.

What treatments are available?
Early diagnosis and treatment are the best ways to prevent kidney damage. Your doctor will give you medicines that will fight the harmful antibodies. Sometimes, the doctor may suggest that you undergo a special blood filtering process (plasmapheresis) to remove harmful antibodies.

What can I expect long-term? Does the disease ever go away?
Usually, your body will only make the antibodies for a short time-anywhere from a few weeks to two years. Once this stops, you should not have any more problems with your lungs. However, your kidneys may have been harmed a little or a lot.

Is there anything I can do to help myself? Do I need to be on a special diet?
Sometimes you will be asked to change your diet to slow down the loss of your kidney function. Your doctor and your dietitian will help you with these changes. Other measures that may help to keep you healthy are: exercise, reducing stress in your life, lowering your cholesterol level and adding fiber to your diet. It is important not to smoke because smoking can increase bleeding in your lungs.

What happens if my kidneys fail? Can I have a transplant?
It is possible that you may need dialysis or a kidney transplant. Before you can get a new kidney, your doctor will check to be sure you do not still have any of the harmful antibodies. The medicines you need to take when you get a new kidney also help to prevent your body from making the harmful antibodies.

Is research being done on Goodpasture's Syndrome?
Yes. currently, there is a lot of interest in finding out what causes the harmful antibodies to be produced. This work may lead to the development of new drugs that are more helpful. Unfortunately, by the time you see your doctor, your kidneys may already be damaged badly.

Research is being done to discover genetic factors that are important in the disease. Also, research is looking at better ways to treat the bleeding that happens with the lung disease.

What else should I know?
Here are some points to remember about Goodpasture's Syndrome:

• The disease is not catching.
• The disease does not usually occur in more than one family member.
• You can have a specific test done that usually will diagnose the disease quickly and accurately.
• You will stop making harmful antibodies after a few weeks to one or two years.
• A kidney transplant can be successful if done after your body has stopped making the harmful antibodies.
• You should not smoke.